More than 80 percent of women in the United States will use hormonal contraception sometime during their reproductive years. Naturally, most women use hormonal contraception (the birth control pill) as a form of contraception, its FDA indication. However, the noncontraceptive benefits and uses are well proven, however, not as well known. Herein, I'll outline most of these benefits.

More than 80 percent of women in the United States will use hormonal contraception sometime during their reproductive years. Naturally, most women use hormonal contraception (the birth control pill) as a form of contraception, its FDA indication. However, the noncontraceptive benefits and uses are well proven, however, not as well known. Herein, I'll outline most of these benefits.

Since oral contraceptives (OCs) containing 150 micrograms of estrogen were introduced in 1960, the dose of estrogen per pill has been markedly reduced. Today, pills may contain as little as 10 micrograms of estrogen — minimimizing estrogen-related risks, while preserving contraceptive effectiveness as well as the noncontraceptive benefits.

Which hormonal contraceptives are beneficial for treatment of painful menstrual cycles?

Dysmenorrhea, or painful menstrual cycles, affects up to 90 percent of young women. The symptoms result from intense uterine contractions that are triggered by the release of endometrial chemicals called prostaglandins. This usually occurs right before and during menses. Oral contraceptives reduce uterine prostaglandins and relieve dysmenorrhea in up to 80 percent of women. Similarly, the contraceptive intravaginal ring (Nuvaring), as well as the single-rod contraceptive implant (Nexplanon) has also been found very effective in reducing such symptoms. Additionally, the Mirena IUD given its ability to reduce or even eliminate menstrual bleeding, also has shown promise in improving painful menses, especially in patients suffering from endometriosis-related pain.

Which hormonal contraceptives are beneficial for menstrual-cycle control?

Oral contraceptives can improve menstrual irregularities, especially those associated with ovulation problems. These conditions span the range of the reproductive years from early teens to menopause where irregular menses share a common thread, irregular and infrequent ovulation.

Important to understand is that unscheduled spotting and light bleeding is common in the first 3-6 months of OC use. Also, women on cyclic hormonal contraception may experience premenstrual symptoms in addition to pelvic pain, headaches, and bloating during the hormone-free week of pills. So skipping this hormone-free week and continuing the pill to the next pack, taking "active" pills, has been used for years for a number of reasons: to combat the unpleasant effects of the placebo week and avoid the menstrual-related symptoms, and delay menstruation for women who anticipate inconvenient menstrual bleeding during travel and/or important life events.

Is hormonal contraception effective as an alternative to surgical therapy for heavy menstrual cycles?

OCs can reduce excessive menstrual bleeding in most affected women and is a reasonable option for the management of heavy bleeding, called menorrhagia. Menstrual blood loss has been shown to be reduced by 50 percent with the use of OCs. Additionally, the Mirena IUD has been proven more effective than OCs in the treatment of heavy bleeding with higher patient satisfaction.

Can hormonal contraception help with premenstrual syndrome (PMS)?

Yes. OCs have shown benefit in reducing PMS symptoms in many patients. One regimen is to take extended cycle, or continuous OCs, by skipping the placebo week for three months at a time, therefore, only having menses four times yearly, thus, menstrual-related symptoms four times yearly rather than monthly.

Can hormonal contraception help with menstrual migraines?

More than half of women who suffer from migraines link their symptoms with menstruation. We know menstrual-related migraines occur in about 10 percent of women. These migraines are experienced solely right before and during early menstruation only. Some patients, actually have such migraines mid-cycle, at the time of ovulation. The use of extended cycle or continuous hormonal contraception reduces or eliminates the hormonal fluctuations thought to precipitate migraine attacks. However, for those women who experience aura-associated migraines, with focal neurologic symptoms, these women should usually not take OCs as the risk of stroke is increased, albeit rare.

Can hormonal contraception help with acne and excessive hair growth?

Yes. All OCs have the potential to improve excessive facial hair and acne after being taken for at least six months. The OCs found to be most effective are Yasmin, Yaz and Ortho-Tricyclen.

What is the role of hormonal contraception in decreasing cancer risk?

There is a 50 percent reduction in uterine cancer risk among women who have used OCs compared with those who have never used them. Longer duration of use further decreases the risk.

Additionally, OCs decrease the risk of ovarian cancer by 25 percent. Again, the longer the duration of use, the greater the risk reduction, amounting to a decrease of approximately 20 percent for every five years of use. Also, OCs are used to protect against ovarian cancer in women with BRCA gene mutations and strong family history of breast, uterine and ovarian cancer.

Furthermore, women may reduce their risk of colorectal cancer by nearly 20 percent by using OCs.

Can hormonal contraception prevent and treat ovarian cysts?

By preventing ovulation, it would make sense that hormonal contraception and OCs, in particular, should prevent ovarian cysts, but there is no good evidence to support this despite common misconceptions and practices. Likewise, hormonal contraception has no utility in the treatment of ovarian cysts already present. Most of them will spontaneously resolve without any treatment.

For the past half century, the FDA-approved "pill" has been successfully used by millions of women for contraception. However the benefits of hormonal contraceptives extend well beyond pregnancy prevention, according to the American College of Obstetricians and Gynecologists and these benefits span the spectrum from the early teens through menopause. Obamacare's recent broad mandate of insurance coverage for contraceptives is fortuitous for American women.

Dr. Christian S. Pope specializes in obstetrics and gynecology. He has offices in New Bedford Mattapoisett and practices at St. Luke's Hospital. He can be reached at 508-999-6245.